This is my clinical pearl story about Relief From Back Pain and Digestive Conditions: Chiropractic Care is Effective. I helped this patient with more than her low back pain. Her chief complaints were low back pain and stiffness.  She was a 58 year old female patient. To be HIPAA compliant, I will call her Ginger instead of her real name. 

Ginger’s back pain had come on 25 years ago following a fall.  She had been under chiropractic care since the fall. Recently, she was under a lot of stress due to family issues.  She hadn’t been eating right or sleeping well either.  Ginger felt all these factors contributed to her back pain, stiffness and digestion problems.  In regards to her digestion problems, she stated “constipation and heartburn” (acid reflux). And Ginger noted a history of a hiatal hernia in her intake.

Ginger’s Examination and Imaging

Upon examination, Ginger tested positive for her neuromusculoskeletal back pain condition.  Her x-rays taken in my office showed degenerative arthritis (osteoarthritis) in her lumbar spine.

What is a Hiatal Hernia and GERD (Gastroesophageal Reflux Disease)?

A hiatal hernia occurs when the upper part of the stomach pushes up into the chest through a small opening in the diaphragm, the muscle that separates the abdomen from the chest.  This results in retention of acid and other contents. These acids and other substances can easily reflux into the esophagus causing heartburn. So if heartburn continues and is more frequent it can become GERD (Gastroesophageal Reflux Disease). Hiatal hernias can occur due to various reasons: born with it, injury to area (e.g. car accident), or obesity. Furthermore, persistent pressure to the surrounding muscles by lifting, chronic coughing, vomiting or straining during a bowel movement can be culprits. 

The symptoms of GERD are also epigastric (upper central region of the abdomen) pain after eating a large meal and lying down. Your esophagus is a muscular tube that connects your mouth and your stomach. The esophageal sphincters (rings of muscle) contract and relax to allow food and liquid to pass.The tone of the lower esophageal sphincter (LES) may decrease with age and also with ingestion of certain foods.  These foods include chocolate, caffeine, fat, and alcohol. In addition, smoking and certain medications also will decrease the tone of the LES, leading to reflux.  Moreover, increased pressure from obesity may aggravate symptoms. However, esophageal reflux can be common in healthy athletes, such as conditioned runners, cyclists, and weightlifters.  Several mechanisms may account for this, including position, Valsalva (forcefully breathing out against closed windpipe), and indirect effects of exercise on lower esophageal tone.


Defining Constipation

It is important to remember that constipation is a relative term. Most physicians would classify a normal bowel movement as one bowel movement per day without straining; others may find passage every 3 to 5 days acceptable. Everyone is different. If you have always had bowel movements every 3 days, this may likely be your normal pattern.   Other factors to define constipation include:

  • Hard stools
  • Infrequent stools (fewer than three per week)
  • Need for excessive straining
  • A sense of incomplete bowel evacuation
  • Excessive time defecating
Spinal Adjustments and Better Digestion

Chiropractors have observed patients with low back pain also frequently have digestion issues (e.g. constipation). The assumption is that this is due to either increased pain with bearing down or simply their nervous system is not functioning optimally.

The nervous system exerts a profound influence on all digestive processes. Some of this control emanates from connections between the digestive system and central nervous system (brain and spinal cord). Even more importantly, the digestive system is endowed with its own, local nervous system referred to as the enteric or intrinsic nervous system. The enteric nervous system, along with the sympathetic and parasympathetic nervous systems, constitute the autonomic nervous system. The autonomic nervous system is the part of the nervous system responsible for control of the bodily functions not consciously directed, such as breathing, the heartbeat, and digestive processes.

Chiropractic “Manual procedures and, specifically, the adjustment are applied to address local NMS (neuromusculoskeletal) disorders and to improve NMS function. A consequence of improved NMS function may be improvement in the body’s ability to self-regulate, thereby allowing the body to seek homeostasis and improved health”.(1)

Simply put, spinal adjustments take pressure off your nervous system and help your body to function optimally. Adjustments help your body seek homeostasis, which is the state of steady internal, physical, and chemical conditions maintained for optimal survival. And good digestion is definitely important for maintaining homeostasis.


Ginger’s Treatment and Outcome

Firstly, Ginger’s treatments included chiropractic adjustment/ manipulation to her lumbar spine and associated regions.  Associated regions were cervical (neck) and thoracic (mid back) spine. Additionally, because of the hiatal hernia, chiropractic manipulation in the epigastric (upper central region of the abdomen) region was performed.  Secondly, soft tissue therapy (myofascial release, pressure point and various post isometric relaxation procedures) was rendered as necessary. Thirdly, modalities (cold/heat therapy and electric muscle stimulation) were administered. Finally, exercises for stretching, strengthening, and better posture were recommended.

I recommended avoidance of alcohol, caffeine, fatty meals, smoking, laxatives and eating large meals. Switching to smaller meals eaten more frequently and going to bed with a partially full stomach helped her heartburn. Ginger practiced proper fluid and diet (fruits, vegetables, fiber) intake. Ginger finally understood that coffee, tea, and sodas do not have the same hydrating effect as water and often result in a diuretic effect. She started a mild exercise to strengthen pelvic/abdominal musculature.  Weight loss was an ongoing struggle for Ginger.  She started to walk with a friend for exercise. 

Ginger’s low back pain and digestion was much improved within a few weeks.  She followed up with her primary care doctor on the hiatal hernia and any medications that may have also lead to her constipation.


A West Palm Beach chiropractor can adjust your spine, putting everything back in place. Realigning your spine alleviates pressure off your nerves and helps your body function at its best.

Are you looking for the best chiropractor in West Palm Beach? Dr. Natalie Meiri can definitely help you.  Find out more about Relief From Back Pain and Digestive Conditions: Chiropractic Care is Effective. Call 561-253-8984 today for an appointment.


Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011 (1)


Meiri Chiropractic